If you’ve been told by a state chiropractic licensing board that you need to take the Special Purposes Examination for Chiropractic (SPEC), you likely have a lot of practical questions.

Because the SPEC is a specialized post-licensure exam rather than a standard student board, clear information can sometimes be hard to find. Below are the definitive answers to the most frequently asked questions about the NBCE SPEC exam.

Frequently Asked Questions

1. What is the NBCE SPEC Exam?

The Special Purposes Examination for Chiropractic (SPEC) is a computer-based post-licensure examination developed by the National Board of Chiropractic Examiners (NBCE). It assesses general clinical knowledge, diagnostic imaging, chiropractic technique, and case management skills for experienced doctors.

2. Who is required to take the SPEC exam?

Chiropractors typically take the SPEC exam for three primary reasons:

• Licensure by Endorsement / Reciprocity: Relocating or expanding practice to a new state where original board scores don't meet current local statutes.

• License Reinstatement: Reactivating a chiropractic license that has lapsed or been inactive for an extended period.

• Board Remediation / Mandates: Fulfilling a state board consent order following a disciplinary audit or malpractice inquiry.

3. Can I sign up for the SPEC exam on my own?

No. You cannot register independently on the NBCE website without prior authorization. You must first apply to the state chiropractic licensing board where you wish to practice. Once the state board approves your request, they will transmit an official authorization to the NBCE, unlocking your registration portal.

4. What is the passing score on the SPEC exam?

The standard passing score on the NBCE SPEC exam is 375. Scores are scaled by the NBCE to ensure consistency across different test forms and administration windows.

5. How much does the SPEC exam cost?

• Initial Examination Fee: $1,500

• Retake Fee (if applicable): $1,200

Testing appointments are held at computer-based Prometric Testing Centers across North America.

6. What is the format of the SPEC exam?

The exam consists of 140 total test items split into two sections:

• 100 Traditional Multiple-Choice Questions (TMCQs): Fact-based items covering patient history, physical/NMS examinations, diagnostic imaging, and adjustive technique setup.

• 40 Extended Multiple-Choice Cases (EMCQs): Case-based scenarios evaluating clinical reasoning, differential diagnosis, red flags, contraindications, and referral timing.

7. How long are score reports valid, and when do I get my results?

Score reports are typically released to both you and your authorizing state board approximately two weeks after the close of the testing window. State board authorizations to sit for the SPEC are generally valid for one year from the date issued.

8. Is the SPEC exam hard for experienced chiropractors?

The exam is not inherently "harder" than pre-licensure boards, but experienced doctors often struggle because they rely on daily clinic habits rather than standardized textbook answers. The SPEC evaluates academic chiropractic care, rigid decision trees, and rare pathologies that you may not see in routine daily practice.

9. What happens if I fail the SPEC exam?

If you do not achieve the passing score of 375, you may reapply to sit for the exam during a subsequent testing window, provided your state board authorization remains valid. The retake fee is $1,200.

10. How long should I study for the SPEC exam?

Most practicing doctors find that a 4- to 6-week study schedule (studying 5 to 8 hours per week) is ideal. This provides sufficient time to review orthopedic tests, neurological levels, X-ray physics, and EMCQ case logic without burning out or disrupting clinic operations.

Simplify Your SPEC Exam Preparation

Don't spend weeks wondering what to study or worrying about test day. At Chiro AlignEd Learning, we provide a direct, high-yield review program engineered specifically for working Doctors of Chiropractic.

• Complete Content Alignment: Structured around the official 100 TMCQ and 40 EMCQ exam format.

• Targeted Practice Banks: Realistic questions with detailed rationales covering NMS diagnosis, imaging, and safety.

• 100% Flexible Access: Study at your own pace from any computer, tablet, or smartphone.

Ready to get back to chiropractic practice with confidence?

Explore our NBCE SPEC Review Course and start prep today. Have questions? Reach out to us with questions via email at [email protected].